Coronavirus (Covid-19): changes to guidance for adult and older people care homes

From: 

• Graham Ellis , Deputy Chief Medical Officer
• Anne Armstrong, Deputy Chief Nursing Officer
• Donna Bell, Director, Mental Health and Social Care

To: Registered care home providers (adults and older people) 

Copied to: 

• Chief Executives NHS Boards and Local Authorities
• Chief Officers Health and Social Care Partnerships
• Chief Social Work Officers 
• Directors of Public Health
• Nurse and Medical Directors
• ARHAI Scotland, Public Health Scotland,
• Care Inspectorate, Scottish Care, CCPS, COSLA

Dear Colleagues

Changes to COVID-19 Guidance for Adult and Older People Care Homes

We are writing to you with updates to guidance for Adult and Older People care homes following a review of remaining pandemic recommendations. We are grateful to you for the exceptional work you and your teams have done and continue to do in responding to the pandemic. You have brought compassion and strength in the most challenging of times, to provide care and support to some of the most vulnerable within our population.

Although SARS-CoV-2 (the virus that causes COVID-19) continues to cause challenges, we are in a much better position than this time last year due to the success of the vaccination programme (including the booster programme) and targeted treatments. 

We acknowledge, however, that at present SARS-CoV-2 infection continues to represent a higher risk to some individuals who are affected by chronic diseases, older, immunocompromised or frail, including those who live in care homes, where communal living in closed settings can present its own challenges in response to infectious diseases. 

Additionally, the emergence of SARS-CoV-2 variants with increased levels of transmissibility has highlighted the need for vigilance and flexibility to respond effectively, as we transition to managing life with COVID-19. However, we now have increased confidence in the vaccine boosters’ ability to mitigate the risk of hospitalisation and the more severe effects of the virus, including death, from the current prominent COVID-19 variant within the community, known as Omicron.

In view of this progress Scottish Government Clinicians, Public Health Scotland (PHS) and ARHAI (Antimicrobial Resistance and Healthcare Associated Infection) Scotland with input from sector representatives have reviewed current protective measures, with full consideration of the wider impact on residents’ health and wellbeing, and their human rights. The review has taken account of the Scottish Governments Covid-19 Strategic Framework (published 22 February 2022) which outlines a vision for care homes as we look to living with COVID-19.

“People living in care homes, which are essentially their homes, should be supported to enjoy fulfilled, meaningful lives free from restrictions as far as possible.”

As a result of this review, we are writing to provide an update on the changes to guidance for care homes. These changes will be reflected in SG webpages and in PHS COVID-19 - information and guidance for care home settings, planned by 31 March 2022, and are summarised in Annex 1 in order for arrangements to be made by adult and older people care homes to adopt them. As ever, local Heath Protection Teams (HPT) can be approached for advice in particular during outbreaks, as well as your local multidisciplinary oversight teams for nursing, care and IPC advice if needed.

We recommend care homes communicate these changes to their staff, residents and visitors to support implementation over the course of the next two weeks, in line with the updates to PHS COVID-19 - information and guidance for care home settings and the PHS Covid-19 Social and Community and Residential Care (SCRC) guidance.

All guidance will continue to be kept under review. It is anticipated that the remaining protective measures such as self-isolation periods for residents (cases and contacts), and restrictions on care home visits by community groups will be reviewed again in April.

We hope these changes assist you in continuing to apply a person-centred approach to care and support for individuals. With your support we can ensure that people living in care homes enjoy fulfilled meaningful lives, free from restrictions as far as possible.

Signed

Graham Ellis , Deputy Chief Medical Officer

Anne Armstrong, Deputy Chief Nursing Officer

Donna Bell, Director, Mental Health and Social Care